Anuj Mundra1, Pradeep R Deshmukh2, Ajay Dawale3. 1. Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India. Electronic address: anuj.mundra87@gmail.com. 2. Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India. 3. District Tuberculosis Office, Wardha, India.
Abstract
INTRODUCTION: Deaths, defaults, relapses, and treatment failures have made the control of TB difficult across the globe. METHODOLOGY: This study is a record-based follow-up of a cohort of patients registered under Revised National Tuberculosis Control Program in the year 2014 in Wardha Tuberculosis Unit, India. Data was collected from the records available at the District Tuberculosis Office. RESULTS: Data of 510 patients was analyzed. The sputum conversion rate was 88%. The overall treatment success rate was 81.9%, and rates of any adverse outcome, deaths, defaults, failure, and shift to Category IV regimen were 32.60/100 person years at risk (PYAR), 16.88/100 PYAR, 11.12/100 PYAR, 3.45/100 PYAR, and 1.15/100 PYAR, respectively. The median times for the above outcomes were 81days, 110days, 66days, 118days, and 237days, respectively. The cumulative probability of occurrence at 6months of any adverse outcome, deaths, default, failure, and shift to Category IV regimen was 0.145, 0.056, 0.088, 0.002, and 0.004, respectively. On multivariate analysis, the determinant of any adverse outcome was age >45years, whereas extrapulmonary disease was protective. The hazard of defaulting was also significantly higher in male patients and those aged >45years. CONCLUSION: Appropriate interventions and program implementation to reduce the adverse treatment outcomes and interruptions will help in improving program performance.
INTRODUCTION:Deaths, defaults, relapses, and treatment failures have made the control of TB difficult across the globe. METHODOLOGY: This study is a record-based follow-up of a cohort of patients registered under Revised National Tuberculosis Control Program in the year 2014 in Wardha Tuberculosis Unit, India. Data was collected from the records available at the District Tuberculosis Office. RESULTS: Data of 510 patients was analyzed. The sputum conversion rate was 88%. The overall treatment success rate was 81.9%, and rates of any adverse outcome, deaths, defaults, failure, and shift to Category IV regimen were 32.60/100 person years at risk (PYAR), 16.88/100 PYAR, 11.12/100 PYAR, 3.45/100 PYAR, and 1.15/100 PYAR, respectively. The median times for the above outcomes were 81days, 110days, 66days, 118days, and 237days, respectively. The cumulative probability of occurrence at 6months of any adverse outcome, deaths, default, failure, and shift to Category IV regimen was 0.145, 0.056, 0.088, 0.002, and 0.004, respectively. On multivariate analysis, the determinant of any adverse outcome was age >45years, whereas extrapulmonary disease was protective. The hazard of defaulting was also significantly higher in male patients and those aged >45years. CONCLUSION: Appropriate interventions and program implementation to reduce the adverse treatment outcomes and interruptions will help in improving program performance.
Authors: Seup Park; Ilham Sentissi; Seung Jae Gil; Won-Seok Park; ByungKwon Oh; Ah Reum Son; Young Ju Kong; Sol Park; Eunseong Paek; Yong Joon Park; Seung Heon Lee Journal: Int J Environ Res Public Health Date: 2019-01-31 Impact factor: 3.390